ROUNDS

Issue 03 — August 2026

After a year of building — it’s real. B2 Direct Care is open.

A monthly check-in from Dr. Brian — practice news, something to cook, and what's on my mind.

From the Practice

Introducing: Hospital-to-Home

Last month I told you Hospital-to-Home was launching in July. Launch wasn’t the right word, more like a slow roll-out. The program has been ready for a while; what’s left is the unglamorous plumbing: final consent language, billing setup, and the day-one workflow that makes the first call after a discharge happen like clockwork instead of luck. A program built to catch people when systems drop them shouldn’t launch with its own loose ends. If someone you love lands in the hospital and this service would be helpful, let me know. Details are also on the website.

Also from July: I spent a few days at the DPC Summit, in sweltering New Orleans with a few hundred physicians building practices like this one. I came home with a full notebook and zero second thoughts about the model.

Field Notes

The cure and the cost

This month’s How Did We Get Here post covers the fifteen years that changed medicine more than any other. If you had a bacterial infection in 1935, your doctor watched you. If you had one in 1955, your doctor cured you. Antibiotics rewrote what a physician could do for a sick person - and in that same generation, medicine became an industry: specialist hierarchies, employer insurance, Medicare, billing codes. Both things happened at once, and we’ve never untangled them. Patients lived longer and were somehow more alone in the system. Doctors saved more lives and knew their patients less. The exam room gained a third party - and it never left. Direct care is, in part, my answer to that: two people in the room again.

→ Read “The Golden Age”

Currently Reading

Finished: Theo of Golden

The member recommendation from our first issue - and one more thank-you for it. The story is simple: an old man arrives in a small Southern town, buys portraits of locals from a coffee shop, then tracks down each subject and gives them their portrait. That’s it. The real story is what happens in those moments - when people are suddenly looked at. Really looked at. Not summed up, not judged, not fixed. Just seen. I finished it speechless, and I’ve been thinking about it in the exam room ever since, because being seen is most of what I believe medicine has lost, and it’s the essence of my patrient-centered care. Read a few pages a day for six months or devour it by a fire in six hours — either way, you won’t be disappointed.

Now reading: I See You’ve Called in Dead by John Kenney — an obituary writer who accidentally publishes his own obit. Early verdict pending; the premise alone earned the spot. I have LAUGHED OUT LOUD, many times.

On the Calendar

Growth: The doors are open. This month there is a slow transition from word-of-mouth to starting to actively promote the practice.

Hospital-to-Home: Now accepting patients

Culinary medicine sessions — in development for early 2027.

• Discovery Call - book here

• Membership info & pricing - check out the new webpage

And as always: reply to this email - I read every one.

Reader Challenge 

Last month, for me:

I asked you to pick one small morning thing and hold it for 30 days. Mine was no devices for the first five minutes, adding five each week.

Some mornings I struggled - the pull to check email or see if a post had picked up likes was real. The mornings that worked: walking Canelo (our geriatric doberman rescue) with the phone left inside, then coffee and a few slow things around the house while thinking through my day. I felt more balanced on those. Noticeably.

And you? Reply and tell me how yours went - streaks, faceplants, and everything in between count.

This month:

Walk every day. Don't worry about time or distance. What I'm actually curious about is which time of day works best for me. I'll report back.

Know someone who needs this?

Forward this email. Word-of-mouth is how a practice like this gets built. No mass advertising. No gimmicks. If you’re receiving this email, you know me and the level of care I give to patients. That’s the best advertisement I have.